IOSR Journal of Pharmacy ISSN: 2250-3013, www.iosrphr.org ‖‖ Volume 2 Issue 4 ‖‖ July-August 2012 ‖‖ PP.04-16 The Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of HIV Type-1 Babalola, Michael Oluyemi. Department of Microbiology, Adekunle Ajasin University, P.M.B. 001, Akungba Akoko, Ondo State, Nigeria. Abstract––I hereby bring into perspective, the Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis of HIV Type -1 and the first proposal for the application of this innovative concept in the field of HIV research, to holistically devise strategies at undermining the prowess of the Human Immunodeficiency Virus and overcoming its scourge. The strengths of HIV are the biological attributes that facilitate the pathogenicity, establishment of infection and spread of the virus. They include , the possession of Reverse Transcriptase enzyme for reverse transcription of RNA genome to DNA, ability to maintain persistence by forming a provirus, ability to specifically target and replicate in the immune cells, antigenic mimicry and adoption of host derived glycan shield for immune evasion, HIV-1 strains harbor enhanced biological fitness upon recombination, HIV has exceptionally high rate of replication and disrupts the Blood- Brain Barrier. The weaknesses of HIV are the internal attributes and requirements for survival of the virus that invariably present as opportunities and targets for elimination. These include: the requirement for CCR5 and CXCR4 chemokine co-receptors for fusion prior to internalization, presence on HIV-1 envelope of conserved determinants that mediate CD4 binding, the Achilles heel of HIV is a tiny stretch of amino acids numbered 421 to 423 on gp 120, the capsid proteins reveal potential weakness at the inner core of the virus, HIV proteins retain virus internal carbohydrate, and the virus thrives on human proteins. The various host factors that were harnessed as opportunities for infection by HIV include, the ability to establish infection via multiple portals of entry, Sexually Transmitted Infections(STIs) increase the susceptibility to HIV-1 infection, STIs boost HIV shedding in the genital tract and amplifies infectiousness, presence of hidden HIV reservoirs that serve as foci of dissemination, the genital anatomical structure of the female genital tract aids biological susceptibility, the immune status of the host, and underlying illness or subsequent exposure to a bandwagon of opportunistic pathogens. The Threats to HIV are the external conditions that are inimical to the virus establishment and which may be harnessed for elimination of the pathogen. They include: limited host reservoir, the virus is susceptible to a Lectin isolated from ripened banana fruits as potent inhibitor of HIV replication, the development and application of Abzymes, development of agents that can selectively target only HIV infected cells, sustenance of global AIDS funding, and evolution of a potent HIV / AIDS Vaccine. I. INTRODUCTION Acquired Immune Deficiency Syndrome (AIDS) is a specific group of diseases or conditions which are indicative of severe immunosuppression related to infection with the Human Immunodeficiency Virus (CDC, 1997). Globally, 33.3 million people live with the virus, of which 2.7 million children under 15 years are estimated to be infected with the virus and 2.6 million were newly infected in 2009 (WHO, 2010). Today, HIV is reputed to be the greatest health crisis the world faces. Since the start of the HIV epidemic 21 million people have died and 57 million people have become infected. There are two main types of the virus; HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood and from mother to child, and they appear to cause clinically similar AIDS. It is now generally accepted that cross-species transmission to humans of SIVcpz in central Africa and SIVsm in West Africa gave rise to HIV-1 and HIV-2, respectively. HIV-1 is prevalent worldwide. It consists of four subgroups designated M (Major), N (New), O (Outlier) and P. These four groups may represent four separate introductions of Simian immunodeficiency virus into humans. Group O and group N- an extremely rare strain that was discovered in Cameroon in 1998 appear to be restricted to West- central Africa. In 2009, a new strain closely relating to gorilla Simian Immunodeficiency Virus was discovered in a Cameroonian woman. It was designated HIV-1 group P (Plantier, 2009). However, more than 90% of HIV-1 infections belong to group M. 4 The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of Hiv Type-1 Fig 1: The different levels of HIV classification (Courtesy Avert.org) The M subgroup has nine (9) genetically distinct subtypes namely A, B,C, D, F, G, H, J, K and CRFs. Occasionally, two viruses of different subtypes can meet in the cell of an infected person and recombine their genetic material to create a new hybrid virus ( a process similar to sexual reproduction, and sometimes called ―viral sex‖ ). Many of these new strains do not survive for long, but those that infect more than one person are known as circulating recombinant forms or CRFs. For example, the CRF A/B is a mixture of subtypes A and B. The HIV-1 subtypes and CRFs are very unevenly distributed throughout the world, with the most widespread being subtypes A and C. Subtype A and CRF A/G predominate in West and Central Africa, with subtype A possibly also causing much of the Russian epidemic ( Bobkov, et al., 2004). Historically, subtype B has been the most common subtype / CRF in Europe, the Americas, Japan and Australia. Although this remain the case, other subtypes are becoming more frequent and now account for at least 25% of new HIV infections in Europe. Subtype C is predominant in Southern and East Africa, India and Nepal. It has caused the world‘s worst HIV epidemics and is responsible for around half of all infections. Subtype D is generally limited to East and Central Africa. CRF A/E is prevalent in South-East Asia, but originated in Central Africa. Subtype F has been found in Central Africa, South America and Eastern Europe. Subtype G and CRF A/G have been observed in West and East Africa as well as Central Europe. Subtype H has only been found in Central Africa; J only in Central America; and K only in the Democratic Republic of Congo and Cameroon. HIV-2 is only prevalent in West Africa, it is less easily transmitted, the period between initial infection and illness is longer, and it consists of six subtypes, namely; A, B, C, D, E and F. Infections with lentiviruses typically show a chronic course of disease, a long period of clinical latency, persistent viral replication and involvement of the central nervous system. Using electron microscopy, HIV-1 and HIV-2 resemble each other strikingly. However, they differ with regard to the molecular weight of their proteins, as well as having differences in their accessory genes. HIV-2 is genetically more closely related to the SIV found in sootey mangabeys (SIVsm) rather than HIV-1 and it is likely that it was introduced into the human population by monkeys. Both HIV-1 and HIV-2 replicate in CD4+ T-cells and are regarded as pathogenic in infected persons, although the actual immune deficiency may be less severe in HIV-2 infected individuals. HIV is a diploid, positive sense, single stranded RNA Virus belonging to the family Retroviridae. HIV- 1 viral particles have a diameter of 100 nm and are surrounded by a lipoprotein membrane. Each viral particle contains 72 glycoprotein complexes, which are integrated into this lipid membrane, and are each composed of trimers of an external glycoprotein gp120 and a transmembrane spanning protein gp41. The bonding between gp120 and gp41 is only loose and therefore gp120 may be shed spontaneously within the local environment. Glycoprotein gp120 may also be detected in the serum as well as within the lymphatic tissue of HIV-infected patients. During the process of budding, the virus may also incorporate different host proteins from the membrane of the host cell into its lipoprotein layer, such as HLA class I and II proteins, or adhesion proteins such as Intracellular Adhesion Molecule-1 (ICAM-1) that may facilitate adhesion to other target cells. The matrix protein p17 is anchored to the inside of the viral lipoprotein membrane. The p24 core antigen contains two copies of HIV-1 RNA. The HIV-1 RNA is part of a protein-nucleic acid complex, which is composed of the nucleoprotein p7 and the reverse transcriptase p66 (RT). The viral particle contains all the enzymatic equipment that is necessary for replication: a Reverse Transcriptase (RT), an Integrase p32 and a Protease p11 enzymes (Fig. 2). 5 The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of Hiv Type-1 Fig. 2: HIV-1 Particle The objective of this presentation is to bring into perspective the characteristic Strengths, the Weaknesses, the Opportunities and Threats to HIV-1 that will enable scientists to consider and devise multifactorial strategies to holistically overcome the scourge of HIV -1 infections. II. THE CONCEPT OF SWOT SWOT is an acronym for Strengths, Weaknesses, Opportunities, and Threats . It was originally designed by the Boston Consulting Group (BCG) in Massachusetts, USA, where Strategic Managers devised the strategy to undermine their competitors and achieved competitive advantage. SWOT analysis can be adapted to scientific research to helps us as Scientists in formulating strategies that augment our research and enable us to understand and devise holistic strategies to combat emerging and recalcitrant infectious pathogens. When the characteristic capacities and the gaps have been identified, we can then devise means of achieving our goals. THE STRENGTHS OF HIV -1 The Strengths of HIV are the biological attributes that facilitate the pathogenicity, establishment of infection and spread of the virus.